Home But Not Healed: The Mental Health Struggles of America’s Veterans

As America celebrates Veterans Day on Nov. 11 to recognize the men and women in the armed forces whose sacrifices in war and peace protect our freedoms, many veterans continue to struggle with their mental health and everyday life following their military service.

Whether it’s related to complications with employment, maintaining healthy relationships, experiencing nightmares or dealing with flashbacks caused by Post-Traumatic Stress Disorder (PTSD), for many veterans, life is a daily challenge that warrants special attention.

“It’s a known fact that many veterans face challenges once they return to civilian life,” said Leslie Fuentes-Nguyen, a licensed marriage and family therapist with Kaiser Permanente Southern California. “PTSD, in particular, is prevalent among veterans and causes many mental health challenges that in turn negatively impacts their quality of life.”

PTSD causes many veterans to have flashbacks, as many relive traumatic events experienced on the battlefield that have become seared in their memories and often adversely affect their mental health, Fuentes-Nguyen said. 

In one major study of 60,000 Iraq and Afghanistan veterans, 13.5% of deployed and non-deployed veterans screened positive for PTSD, while other studies show the rate to be as high as 20% to 30%. As many as 500,000 U.S. troops who served in those wars may have been diagnosed with PTSD, according to the study. 

“PTSD affects veterans in several ways,” Fuentes-Nguyen explained.  “However, there’s often a common denominator: Those with PTSD often experience significant challenges when it comes to managing daily activities such as work, going to school or having healthy relationships with your spouse, children, friends and loved ones. That can often lead to social withdrawal, anxiety, shame, sleep disorders, or even suicide.”

Fuentes-Nguyen noted veterans with PTSD often experience triggers that equates to their nervous system becoming hijacked by a panic reaction, which can cause you to fight (get angry), flight (avoid) or freeze (feel numb).

“Certain factors increase the chances of someone developing PTSD, including having directly experienced or repeatedly witnessed the aftermath of a very intense or long-lasting traumatic event, which is common among many veterans of war,” said Fuentes-Nguyen, who practices in Los Angeles.

According to mental health experts, the following coping skills for veterans with PTSD can be helpful:

1. Grounding and Relaxation Techniques – Used to reduce anxiety and bring focus back to the present moment.

• Deep breathing: Try “4-7-8 breathing” (inhale 4 seconds, hold 7, exhale 8).
• Progressive muscle relaxation: Tense and release muscle groups to ease physical tension.

2. Emotional Regulation – Helps manage anger, guilt, sadness or shame common in PTSD.

• Use “cool down” plans: Step away, breathe, or take a walk when tension rises.
• Practice self-compassion: Remind yourself that having symptoms is not a personal failure.

3. Cognitive Coping Strategies – Focus on changing unhelpful or negative thought patterns.

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• Reality testing: Ask yourself, “What evidence supports or challenges this thought?”
• Reframing: Replace thoughts like “I’m weak” with “I survived something hard, and I’m healing.”

4. Behavioral and Lifestyle Strategies – Support overall well-being and daily functioning.

• Physical activity: Exercise reduces stress hormones and improves sleep.
• Sleep hygiene: Set a regular sleep schedule; avoid screens and caffeine before bed.
• Healthy routines: Eat balanced meals and maintain structure to increase stability.
• Limit alcohol or substance use: These can worsen symptoms and sleep problems.

5. Social and Supportive Coping – Reduces isolation and builds resilience.

• Peer support groups: Connection with other veterans who understand the experience.
• Family communication: Share what helps (e.g., needing quiet time or space when triggered).
• Volunteer or purposeful activity: Reinforces a sense of mission and contribution.
• Therapeutic alliances: Work with a trusted therapist or counselor experienced in trauma.

6. Crisis and Safety Planning – For moments of high distress or suicidal thoughts.

• Crisis plan: Write down signs you’re in crisis, coping tools, and contacts for support.
• Emergency contacts:
  • Veterans Crisis Line: Dial 988, then press 1 (24/7, confidential).
  • Text: 838255
  • Chat: VeteransCrisisLine.net/Chat

7. Positive Coping and Meaning-Making – Helps Veterans reconnect with purpose and identity.

• Spiritual or faith-based practices (if meaningful to the individual).
• Creative outlets: Art, music or writing can process trauma indirectly.
• Nature exposure: Hiking, fishing, gardening or spending time outdoors.
• Mindful service: Helping others can restore purpose and empowerment.

As there will be times when PTSD can cause severe anxiety and other mental health challenges, Fuentes-Nguyen stressed the importance of knowing when veterans and their loved ones should seek professional help.

“If you start thinking about hurting yourself or others, then call 911,” she advised. “Additionally, if your symptoms get worse, or you feel your state of mental health isn’t improving, contact your health care provider.”

Kaiser Permanente offers valuable care instructions